Healthcare Provider Details
I. General information
NPI: 1841389731
Provider Name (Legal Business Name): DARREL L HUFF MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/11/2006
Last Update Date: 06/20/2024
Certification Date: 06/20/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8244 E US HIGHWAY 36 STE 200
AVON IN
46123-9621
US
IV. Provider business mailing address
1100 SOUTHFIELD DR SUITE 1370
PLAINFIELD IN
46168-4498
US
V. Phone/Fax
- Phone: 317-272-4242
- Fax: 317-272-6640
- Phone: 317-837-5571
- Fax: 317-837-5580
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | 01043540 |
| License Number State | IN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: